Individual provider Active NPI

Brianna Hall

  • Clinical Social Worker
  • Beverly, MA
National Provider Identifier
1013526763
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW1120410 Issued in MA
Practice address
500 Cummings Ctr Ste 3100
Beverly, MA 01915-6540
Phone
(978) 716-6774
NPI assigned
Jul 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Clinical Social Worker 1041C0700X LICSW1120410 MA Primary

Addresses

Primary practice location

500 Cummings Ctr Ste 3100
Beverly, MA 01915-6540

Mailing address

1702 Broughton Dr
Beverly, MA 01915-1848
Phone (978) 716-6774

Other practice location 1

57 Wingate St Ste 401
Haverhill, MA 01832-5759
Phone (978) 716-6774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250220001210 MA Practitioner - Clinical Social Worker 1153841119 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICSW1120410MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Behavioral Health Corporation CurrentSince Jan 6, 2025 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. Clinical CurrentSince Oct 5, 2025 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Oct 5, 2025 Accepting new patients
Nova Initia Counseling, LLC Past Accepting new patients

Locations

40 Shattuck Rd
Ste 250
Andover, MA 01810
Phone (603) 505-6847

500 Cummings Ctr
Ste 3100
Beverly, MA 01915
Phone (978) 716-6774

800 Cummings Ctr
Ste 266T
Beverly, MA 01915

199 Rosewood Dr
Ste 250
Danvers, MA 01923
Phone (978) 867-7756

12 Methuen St
Ste 3
Lawrence, MA 01840
Phone (978) 683-3128

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1013526763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 BROUGHTON DR",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151848",
            "telephone_number": "978-716-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CUMMINGS CTR STE 3100",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156540",
            "telephone_number": "978-716-6774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 Wingate St Ste 401",
            "address_purpose": "LOCATION",
            "city": "Haverhill",
            "state": "MA",
            "postal_code": "018325759",
            "country_code": "US",
            "telephone_number": "978-716-6774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "BRIANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-29",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW1120410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.